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Use of Community Services by Seniors Before and After an Emergency Visit*

  • Jane McCusker (a1) (a2), Orly Ardman (a3), François Bellavance (a4), Éric Belzile (a1), Sylvie Cardin (a5) and Josée Verdon (a6)...

Résumé

À l'aide de données provenant d'une cohorte de 1 352 personnes àgées demeurant dans la communauté et ayant visité l'urgence d'un centre hospitalier, nous avons étudié la prévalence (avant la visite à l'urgence) et l'incidence (pendant une période de suivi de six mois) de l'utilisation des services communautaires de santé ainsi que les facteurs reliés à l'utilisation de ces services. Les données ont été recueillies lors d'entrevues à l'urgence et au téléphone lors du suivi. Avant la visite à l'urgence, 59,8 pour cent des patients avaient au moins une incapacité en regard aux activités de la vie quotidienne (AVQ); 16,8 pour cent des patients ayant une incapacité recevaient des services communautaires. Parmi les patients qui ne recevaient pas ces services auparavant, 45,4 pour cent ont développé une nouvelle incapacité pour les AVQ pendant les trois mois suivant la visite à l'urgence; et 23,5 pour cent des patients avec une nouvelle incapacité ont commencé à recevoir des services communautaires. En contrôlant pour l'ampleur des besoms, les patients admis à l'hôpital se sont avérés être plus susceptibles de recevoir des services pendant la période de suivi que ceux ayant reçu leur congé de l'urgence. Il existe probablement de nombreux besoins non comblés pour les services communautaires dans cette population.

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1.Currie, C, Lawson, P, Robertson, C, Jones, A.Elderly patients discharged from accident and emergency departments — their dependency and support. Arch EmergMed 1984; 9:813.
2.Denman, SJ, Ettinger, WH, Zarkin, BA, Coon, PJ, Casani, JA.Short-term outcomes of elderly patients discharged from an emergency department. J Am Geriatr Soc 1989; 37(10):937–43.
3.Brookoff, D, Minniti-Hill M. Emergency department-based home care. Arm Emerg Med 1994; 23(5):1101–6.
4.McCusker, J, Healey, E, Bellavance, F, Connolly, B.Predictors of repeat emergency department visits by elders. Acad Emerg Med 1997; 9:9–8.
5.Aday, L, Andersen, R.A framework for the study of access to medical care. Health Serv Res 1974; 208–20.
6.Coulton, C, Frost, AK. Use of social and health services by the elderly. J Health Soc Behav 1982; 23(4):330–9.
7.Shapiro, E, Tate, R. The use and cost of community care services by elders with unimpaired cognitive function, with cognitive impairment/no dementia and with dementia. Can J Aging 1997; 16(4):665–81.
8.Wan, T.Functionally disabled elderly: Health status, social support, and use of health services. Res Ageing 1987; 9(1):6178.
9.Branch, L, Wetie, T, Scherr, P et al. A prospective study of incident comprehensive medical home care use among the elderly. Am J Public Health 1988; 78(3):255‐9.
10.Penning, M.Cognitive impairment, caregiver burden, and the utilization of home health services. J Aging Health 1995; 7(2):233–53.
11.Solomon, D, Wagner, D, Marenberg, M, Acampora, D, Cooney, LJ, Inouye, S.Predictors of formal home health care use in elderly patients after hospitalization. J Am Geriatr Soc 1993; 9:9–6.
12.Darby, P.Quick response teams: a new approach in utilization management. Leadership 1992; (Sept/Oct):2731.
13.Rajacich, D, Cameron, S.Preventing admissions of seniors: into the emergency department. J Gerontol Nurs 1995; (October):3641.
14.Dawson, JI, Critchley, L.Community-hospital partnerships: the quick response team. J Nurs Admin 1992; 22(11):33–9.
15.Boyack, V, Bucknum, A.The quick response team: A pilot project. Soc Work Health Care 1991; 16(2):5568.
16.Brazil, K, Bolton, C, Ulrichsen, D, Knott, C.Substituting home care for hospitalization: The role of a quick response service for the elderly. J Community Health 1998; 23(1):2943.
17.McCusker, J, Bellavance, F, Cardin, S, Trépanier, S, Ardman, O, Verdon, J.Detection of older people at increased risk of adverse health outcomes after an emergency visit: The ISAR screening tool. J Am Geriatr Soc 1999; 47(10):1229–37.
18.Canadian Study of Health and Aging Working Group. Patterns of caring for people with dementia in Canada. Can J Aging 1994; 13(4):470–87.
19.Fillenbaum, G.Multidimensional functional assessment: the OARS methodology — A manual. 2nd edition. Durham, NC: Center for the Study of Aging and Human Development, Duke University, 1978.
20.Shinar, D, Gross, C, Brohstein, K et al. Reliability of the Activities of Daily Living Scale and its use in telephone interview. Arch Phys Med Rehabil 1987; 68(10):723–8.
21.McCusker, J, Bellavance, F, Cardin, S, Belzile, É.Validity of an activities of daily living questionnaire among older patients in the emergency department. J Clin Epidemiol 1999; 52(11):1023–30.
22.Spector, WD, Katz, S, Murphy, JB, Fulton, JP. The hierarchical relationship between activities of daily living and instrumental activities of daily living. J Chron Dis 1987; 40(6):481–9.
23.Erkinjuntti, T, Sulkava, R, Wikstrom, J, Autio, L.Short Portable Mental Status Questionnaire as a screening test for dementia and delirium among the elderly. J Am Geriatr Soc 1987; 35(5):412–6.
24.Smyer, MA, Hofland, BF, Jonas, EA. Validity study of the Short Portable Mental Status Questionnaire for the elderly. J Am Geriatr Soc 1979; 27(6):263–9.
25.National Ambulatory Medical Care Survey. Reason for visit classification and coding manual. Hyattsville, MD: United States Department of Health & Human Services, 1994.
26.World Health Organization. The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva, Switzerland: World Health Organization, 1993: 248.
27.Hebert, R, Bravo, G, Korner-Bitensky, N, Voyer, L.Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline. Age Ageing 1996; 9:967.
28.Hosmer, D, Lemeshow, S.Applied logistic regression. New York, NY: Wiley, 1989.
29.SAS, Version 6.12. Cary, NC, USA: SAS Institute Inc.
30.Brown, L, Potter, J, Foster, B.Caregiver burden should be evaluated during geriatric assessment. J Am Geriatr Soc 1990; 9:960.
31.Sinoff, G, Clarfield, A, Bergman, H, Beaudet, M.A two-year follow-up of geriatric consults in the emergency department. J Am Geriatr Soc 1998; 9:920.
32.Gerson, LW, Rousseau, EW, Hogna, TM, Bernstein, E, Kalbfleisch, N.Multicenter study of case finding in elderly emergency department patients. Acad Emerg Med 1995; 9:934.

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Use of Community Services by Seniors Before and After an Emergency Visit*

  • Jane McCusker (a1) (a2), Orly Ardman (a3), François Bellavance (a4), Éric Belzile (a1), Sylvie Cardin (a5) and Josée Verdon (a6)...

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